| Chanate Child Opt North | |
|
3322 Chanate Rd #49269n Santa Rosa CA 95404-1708 | |
| (707) 565-4810 | |
| Not Available |
| Full Name | Chanate Child Opt North |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 3322 Chanate Rd, Santa Rosa, California |
| Authorized Official Name and Position | Diana L. Stornetta (ACCOUNTANT III COMPLIANCE) |
| Authorized Official Contact | 7075654782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chanate Child Opt North 3322 Chanate Rd #49269n Santa Rosa CA 95404-1708 Ph: (707) 565-4810 | Chanate Child Opt North 3322 Chanate Rd #49269n Santa Rosa CA 95404-1708 Ph: (707) 565-4810 |
| NPI Number | 1336286244 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 02/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336286244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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